Despite reports of expanding rates of injecting drug use in a new list of countries around the world, no new countries have established needle and syringe programmes in the last three years.

This is one of the headline findings of an exhaustive review of the state of harm reduction services around the world conducted by international NGO Harm Reduction International, presented at the 25th International Harm Reduction Conference (HR17) in Montréal last week.

The absence of any increase in the number of countries that report starting needle and syringe programming is significant. Katie Stone, Research Analyst with Harm Reduction International describes this problem:

In a study tracking numbers of new infections of hepatitis C and rates of sharing syringes among people injecting drugs over two and a half decades, differences in infection trends emerged across cities in North America, Australia and the Netherlands, researchers report in a recent Clinical Infectious Diseases. While rates of new infections remained high in Baltimore, San Francisco and Montreal, they dropped in Sydney, Melbourne and most precipitously in Amsterdam.

Authors of the study, who say theirs appears to be the first study of hepatitis C incidence and injecting behavior across cities and over 25 years, say the differences in incidence reflect differences in policies to reduce the harm of injecting drug use. The Netherlands, which introduced to needle and syringe provision for people who injected drugs in 1981, had expanded its efforts to ensure that sterile needles and syringes, along with health information and services were available throughout the communities where they were needed to discourage needle sharing. Australia had legalized and provided funding for needle and syringe provision accessed by 80 percent or more of people injecting drugs. In all three cities, opioid substitution therapy also was readily available, reducing needs to use and share injecting equipment. In the U.S. cities, where federal funding for needle and syringe programs only became available under limited conditions in the last year, 40 percent or more of people who injected drugs continued to share injecting equipment, while opioid substitution therapy access remained stymied by restrictions and long waiting lists. Both harm reduction measures — Needle and syringe provision, as well as opioid substitution therapy were much more readily available in Montreal, but there, researchers suggest, those measures were insufficient in the face of higher rates of cocaine injection.

Researchers at UCSF and their colleagues have found that Hepatitis C virus (HCV) infection among people who inject drugs remains high and stable in some North American cities but incidence has dropped and remained low in some Australian and European cities. These differences in HCV infection rates likely reflect differences in the level and timing of programs to increase access to sterile injecting equipment and medically assisted treatment for opioid dependence, two harm-reduction programs shown to prevent transmission of HCV.

The lead author, Meghan Morris, PhD, MPH, assistant professor of epidemiology and biostatistics at UCSF, and the team analyzed epidemiological data from eight similar cohort studies of participants who were recruited through community outreach and were HCV negative when they entered study.

SURGEON GENERAL’S REPORT ON ALCOHOL, DRUGS, AND HEALTH

The first-ever Surgeon General’s Report on Alcohol, Drugs, and Health reviews what we know about substance misuse and how you can use that knowledge to address substance misuse and related consequences. Read the executive summary.

The last chapter of the Report presents a vision for the future, five general messages, their implications for policy and practice, and recommendations for specific stakeholder groups. Read the vision for the future.

Supplementary materials are available that outline the Report’s key messages, highlight its findings and recommendations for specific audiences, and help you spread the word to others. Check out the supplementary materials.

In the summer of 2015, local officials concerned with the skyrocketing rates of drug overdoses and overdose deaths in Cabell County put together an initiative aimed at lessening the negative impacts associated with illicit drug use and steering addicts toward treatment.

That initiative, called a harm reduction program, got its start in September 2015. Now, after a little more than a year, an assessment of that strategy suggests that the program has had a positive impact – even though the drug epidemic is still very much with us.

The program was proposed by the Mayor’s Office of Drug Control Policy and has been implemented by the Cabell-Huntington Health Department. Among its elements was a syringe-exchange program, aimed at reducing the county’s relatively high rate of hepatitis C cases and to fend off an outbreak of HIV by giving intravenous drug users clean needles in exchange for used ones. Another aspect was providing family members of drug users doses of the overdose-reversing drug naloxone and providing training on how to use it. Yet a third key strategy was to provide drug users counseling and education on drug use and inform them of addiction-treatment options.

Note: This news story includes a video that includes our very own Matthew Zielske.

As the number of suspected fatal heroin overdoses continues on a record-setting pace in Vanderburgh County, the demand for services from area organizations continues to rise. Officials from AIDS Resource Group in Evansville report increases in the number of people being tested for HIV in addition to those wanting ham reduction kits, which contain potentially life-saving materials needed to clean and sterilize needles.

According to the Vanderburgh County Coroner’s Office, there have been 18 suspected fatal heroin overdoses so far in 2016. There were eight heroin overdoses in 2014 and 2015 combined.

The record-setting pace doesn’t appear to be slowing down any time soon.

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